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Alshaikh AA, Alqarni HM, Hassan Assiri HA, Shlwan MA, AlJebreel MA, Almuaddi AS, Asiri MA, Almuidh FNA, Al Qasim NY, Alshahrani OA, Ghazy RM. Knowledge, Attitude, and Practice of Diabetic Foot Ulcer Care in Asser Region: A Cross-Sectional Study. Cureus 2023; 15:e42807. [PMID: 37664377 PMCID: PMC10470658 DOI: 10.7759/cureus.42807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Foot problems continue to be the leading cause of hospital admissions among people with diabetes. The objective of this study was to explore and assess the knowledge and attitudes of individuals about diabetic foot ulcers in the Asser region, Saudi Arabia. Methodology An anonymous, online, cross-sectional survey was conducted. The questionnaire was distributed through commonly used social media platforms such as Instagram, Facebook, and Twitter. Results A total of 445 participants were included in this survey. Overall, 37.1% (165) were aged 18-25 years, 64.3% (286) were women, and 75.7% (337) had university-level education. A significant number of participants had relatives with diabetes (57.1%, 254), while a smaller percentage reported having diabetes themselves (7.3%, 33), and a substantial proportion were neither diabetic nor had a relative with diabetes (35.6%, (158). Nearly two-fifths of the participants (37.8%, 168) received information about diabetes and diabetic foot care from physicians, and 34.1% (152) of the participants accessed information online. There were significant differences between those who did not have diabetes mellitus (DM) and those who had DM or whose relatives were diabetic in responses to the following questions: "Do you think that diabetes may cause gangrene in the foot?" (50.9% (205) vs. 45.7% (32), p = 0.019), "Do you think that preventing diabetic foot ulcers is more important than treating diabetic foot ulcers?" (60.8% (228) vs. 46.9% (60), p = 0.002), and "Do you think it is important to constantly monitor diabetic foot wounds?" (63.1% (200) vs. 30.4% (17), p < 0.001). There was a statistically significant difference between groups in the practice of daily foot checks, washing feet, moisturizing feet, keeping feet away from hot and cold, and nail care (p < 0.001). Conclusions The participants in the study showed a lack of knowledge regarding diabetic foot care, indicating the potential for better outcomes through the implementation of enhanced health education programs.
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Affiliation(s)
| | - Hassan M Alqarni
- Al-Mahala Primary Health Care Center, Ministry of Health, Abha, SAU
| | | | | | | | | | | | | | | | | | - Ramy M Ghazy
- Department of Public Health, Alexandria University, Alexandria, EGY
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B. G. S, V. U, Shivaram JM, Belehalli P, M. A. S, H. C. C, Sikkandar MY, Brioschi ML. Diabetic Foot Assessment and Care: Barriers and Facilitators in a Cross-Sectional Study in Bangalore, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5929. [PMID: 37297533 PMCID: PMC10252617 DOI: 10.3390/ijerph20115929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
(1) Background: This cross-sectional study aims to highlight the assessment and foot care practices in an advanced clinical setting, the clinical characteristics of the patients, and to understand the barriers and facilitators for effective foot care from the perspectives of healthcare practices, resources, and patients' socioeconomic and cultural practices, and other aspects in terms of new technologies for effective foot care such as infrared thermography. (2) Methods: Clinical test data from 158 diabetic patients and a questionnaire to assess the foot care education retention rate were collected at the Karnataka Institute of Endocrinology and Research (KIER) facility. (3) Results: Diabetic foot ulcers (DFUs) were found in 6% of the examined individuals. Male patients were more likely to have diabetes complications, with an odds ratio (OR) of 1.18 (CI = 0.49-2.84). Other diabetes problems raised the likelihood of DFUs by OR 5 (CI = 1.40-17.77). The constraints include socioeconomic position, employment conditions, religious customs, time and cost, and medication non-adherence. The attitude of podiatrists and nurses, diabetic foot education, and awareness protocols and amenities at the facility were all facilitators. (4) Conclusions: Most diabetic foot complications might be avoided with foot care education, regular foot assessments as the standard of treatment, and self-care as a preventive/therapeutic strategy.
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Affiliation(s)
- Sudha B. G.
- Department of Computer Science and Engineering, B.M.S. College of Engineering, Bangalore 560019, India
| | - Umadevi V.
- Department of Computer Science and Engineering, B.M.S. College of Engineering, Bangalore 560019, India
| | - Joshi Manisha Shivaram
- Department of Medical Electronics, B.M.S. College of Engineering, Bangalore 560019, India
| | - Pavan Belehalli
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Shekar M. A.
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Chaluvanarayana H. C.
- Department of Podiatry, Karnataka Institute of Endocrinology and Research, Bangalore 560019, India
| | - Mohamed Yacin Sikkandar
- Medical Equipment Technology, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Marcos Leal Brioschi
- Medical Thermography Service, Neurology Department, Hospital das Clínicas, Sao Paulo University, Sao Paulo 01246-903, Brazil
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Reddie M, Shallal C, Frey D. A Scoping Review of Footwear Worn by People With Diabetes in Low- and Middle-Income Countries: Implications for Ulcer Prevention Programs. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:GHSP-D-22-00392. [PMID: 37116930 PMCID: PMC10141434 DOI: 10.9745/ghsp-d-22-00392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/29/2023] [Indexed: 04/30/2023]
Abstract
International guidelines advise people with diabetes to wear close-toed, thick-soled footwear to protect against foot ulceration. However, this type of footwear is incompatible with some of the cultures, climates, and socioeconomic conditions in many low- and middle-income countries (LMICs). This scoping review aims to summarize what is known about footwear used by people with diabetes in LMICs and consider whether international diabetic foot guidelines are practical and actionable in these contexts, given current practices. PubMed, CINAHL, Scopus, Embase, Web of Science, Latin American and Caribbean Health Sciences Literature, and African Journals Online were searched for articles that documented the footwear used by people with diabetes in LMICs. Twenty-five studies from 13 countries were eligible for inclusion and indicated that a large proportion of people with diabetes wear footwear that is considered inappropriate by current guidance, with sandals and flip-flops being popular choices in a majority of the studies. Reasons given for these choices include poverty, lack of awareness of and provider communication about the importance of footwear selection, comfort, and cultural norms. We recommend that LMIC health care systems relying on international guidelines critically consider whether their recommendations are sensible in their settings. Diabetic foot experts and LMIC-based health care stakeholders should collaborate to design alternative guidelines, strategies, and interventions specifically for LMIC contexts to increase preventative practice feasibility and uptake.
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Affiliation(s)
- Madison Reddie
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Christopher Shallal
- Harvard University-Massachusetts Institute of Technology Health Sciences and Technology, Cambridge, MA, USA
| | - Daniel Frey
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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Elafros MA, Callaghan BC, Skolarus LE, Vileikyte L, Lawrenson JG, Feldman EL. Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review. Rev Endocr Metab Disord 2023; 24:221-239. [PMID: 36322296 PMCID: PMC10202021 DOI: 10.1007/s11154-022-09754-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
Diabetic retinopathy, neuropathy, and nephropathy occur in more than 50% of people with diabetes, contributing substantially to morbidity and mortality. Patient understanding of these microvascular complications is essential to ensure early recognition and treatment of these sequalae as well as associated symptoms, yet little is known about patient knowledge of microvascular sequalae. In this comprehensive literature review, we provide an overview of existing knowledge regarding patient knowledge of diabetes, retinopathy, neuropathy, and nephropathy. We also discuss health care provider's knowledge of these sequalae given that patients and providers must work together to achieve optimal care. We evaluated 281 articles on patient and provider knowledge of diabetic retinopathy, neuropathy, and nephropathy as well as predictors of improved knowledge and screening practices. Results demonstrated that patient and provider knowledge of microvascular sequalae varied widely between studies, which may reflect sociocultural or methodologic differences. Knowledge assessment instruments varied between studies with limited validation data and few studies controlled for confounding. Generally, improved patient knowledge was associated with greater formal education, longer diabetes duration, and higher socioeconomic status. Fewer studies examined provider knowledge of sequalae, yet these studies identified multiple misconceptions regarding appropriate screening practices for microvascular complications and the need to screen patients who are asymptomatic. Further investigations are needed that use well validated measures, control for confounding, and include diverse populations. Such studies will allow identification of patients and providers who would benefit from interventions to improve knowledge of microvascular complications and, ultimately, improve patient outcomes.
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Affiliation(s)
| | | | - Lesli E Skolarus
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Loretta Vileikyte
- Division of Diabetes, Endocrinology, and Gastroenterology, University of Manchester, Manchester, UK
- Department of Endocrinology and Dermatology, University of Miami, Miami, FL, USA
| | - John G Lawrenson
- School of Health and Psychological Sciences, City, University of London, London, UK
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
- Department of Neurology, Michigan Medicine, University of Michigan, 48109, Ann Arbor, MI, USA.
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Patients' Perceptions of Reasons Contributing to Delay in Seeking Help at the Onset of a Diabetic Foot Ulcer: A Grounded Theory Study. J Wound Ostomy Continence Nurs 2022; 49:481-487. [PMID: 36108232 DOI: 10.1097/won.0000000000000913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to explore patients' perception of reasons contributing to delay in seeking help and referral to a wound care specialist at the onset of a diabetic foot ulcer (DFU). DESIGN Constructivist grounded theory study. SUBJECTS AND SETTING The sample comprised 30 individuals with active DFU attending a wound care clinic in southeastern Ontario, Canada. METHODS Participants were selected through purposive and theoretical sampling. Semistructured interviews were conducted with participants until no new properties of the patterns emerged. All interviews were transcribed, coded, and analyzed using methods informed by constructivist grounded theory. RESULTS The reasons contributing to delay to seek help and referral to a wound care specialist were (1) limited knowledge about foot care, (2) unaware of diabetic foot problems, (3) underestimation of ulcer presentation, (4) I thought I could fix it myself, (5) inaccurate diagnosis, and (6) trial and error approach by a nonspecialized wound care provider. CONCLUSIONS Study findings suggest that patients and primary healthcare providers need additional education regarding the management of diabetic foot disease and DFU.
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Jia H, Wang X, Cheng J. Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China. Front Public Health 2022; 10:876105. [PMID: 35669753 PMCID: PMC9163951 DOI: 10.3389/fpubh.2022.876105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background The diabetic foot is a global threat to public health because it can result in infection and amputation, as well as cause the patient to experience considerable pain and incur financial costs. The condition of patients with diabetic foot in North China is distinguished by more severe local ulcers, a worse prognosis, and a longer duration of disease than that of patients with diabetic foot in the south. Through appropriate preventive measures, the diabetic foot can be effectively avoided. This study assesses the existing knowledge, attitudes and practices associated with diabetic foot prevention among adults with diabetes living in rural areas of North China. Method This cross-sectional survey included 1,080 rural adults from North China, cluster sampled 12 villages and surveyed diabetic patients without diabetic foot who participated in community diabetes management. The self-administered knowledge and attitude questionnaire and the Chinese version of the Nottingham Assessment of Functional Foot-care Questionnaire were used. Result Of the 1,080 subjects, 51.6% received moderate knowledge scores, 63.9% had a positive attitude and 71.4% received poor practice scores. In terms of knowledge, parameters of knowledge about foot examinations and treatment of foot problems showed the lowest scores. In terms of practice, in line with the results of the low knowledge score, parameters of the pursuit of medical treatment for foot problems and routine foot examinations were associated with the lowest scores. Multiple regression analysis revealed that participants who were current smokers (β: -0.049, 95% CI: -0.088 to -0.011) had lower knowledge scores than those who never smoke; participants who were current smokers (β: -0.818, 95% CI: -1.067 to -0.569) and past smokers (β: -0.299, 95% CI: -0.485 to -0.112) had lower attitude scores than those who had never smoked; participants who had higher knowledge scores (β: 1.964, 95% CI: 1.572-2.356) achieved higher scores on attitudes; women had better practice scores than men (β: 0.180, 95% CI: 0.122-0.239); patients with a long diabetes duration (6-10 years) had better practice scores than those who had a short diabetes duration (<2 years; β: 0.072, 95% CI: 0.012-0.131). Knowledge (β: 0.130, 95% CI: 0.001-0.258) and attitudes (β: 0.268, 95% CI: 0.249-0.287) were significantly associated with good practices. Conclusions Increasing knowledge regarding diabetic foot would help instill positive attitudes and cultivate better practices toward diabetic foot prevention. The results of this study may help guide future promotional resources to those groups most in need, which may help lower the incidence of diabetic foot among adults in North China.
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Affiliation(s)
- Huimin Jia
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaocheng Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, Taiyuan, China
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Awwad KA, Abu-Khader IR. Cross-Sectional Study Concerning the Knowledge, Attitude, and Practice of People With Diabetes Regarding the Prevention of Foot Ulcers in a Community. Clin Diabetes 2022; 40:298-304. [PMID: 35979326 PMCID: PMC9331621 DOI: 10.2337/cd21-0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Foot ulceration is a serious problem among people with diabetes. This study assessed the knowledge, attitude, and practice of 483 people with diabetes with regard to the prevention of diabetic foot ulcers (DFUs). Data were collected using a valid and reliable questionnaire, and logistic regression was carried out to predict the effect of statistically significant independent variables on the scores of dependent variables. A significant association was found between knowledge and attitude about DFU prevention. Individuals who were unmarried were more likely to have higher knowledge scores than those who were married, and those who had university and secondary education were more likely to have higher attitude and practice scores than other groups. Overall, however, only a small percentage of study participants achieved high scores for knowledge, practice, and attitude in this study.
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Affiliation(s)
- Khalaf Abdelfattah Awwad
- Department of Nursing, Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | - Imad Rasheed Abu-Khader
- Department of Nursing, Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
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Dhandapani S, Kambar S, Hiremath M. Practice and associated factors regarding foot care among diabetes mellitus patients attending a rural primary health center in South India. Adv Biomed Res 2022; 11:45. [PMID: 35814301 PMCID: PMC9259454 DOI: 10.4103/abr.abr_279_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 04/12/2021] [Accepted: 10/13/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Diabetes mellitus patients are more likely to undergo nontraumatic foot or leg amputations because they have decreased circulation to the feet or reduced sensation. This condition may cause ulcerations, infections, and delayed wound healing, leading to amputations. Adequate knowledge and practices regarding foot care will be vital in the prevention of diabetic foot complications. Hence, this study aimed to determine the level of knowledge and practices of foot care among diabetes mellitus patients attending a rural primary health center in Belagavi-South India. Materials and Methods: A cross-sectional study was conducted in the rural field practice area of J.N. Medical College, Belagavi, for 7 months (November 2019 to May 2020). A pretested questionnaire was administered to 461 diabetes patients attending the health center. A written informed consent was obtained from each participant. They were interviewed with a questionnaire consisting of 15 “yes” or “no” questions, each on foot care knowledge and practice. Results: The mean age of the study participants was 50.28 ± 9.48 years. The mean duration of diabetes was 10.69 ± 7.09 years. Majority, i.e., 296 (64.2%) participants showed satisfactory knowledge and 293 (63.6%) showed satisfactory practice. Only 97 (21%) had poor knowledge, 90 (19.5%) had poor practice, 68 (14.8%) patients had good knowledge, and 78 (16.9%) had good practice about diabetic foot care. Conclusions: The low level of knowledge and practice in patients with diabetes regarding foot care necessitates an educational program to increase awareness related to foot complications of diabetes, thereby motivating diabetic patients to incorporate foot care practices in their day-to-day routine.
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Al Amri AM, Shahrani IM, Almaker YA, Alshehri DM, Argabi MA, Alghamidi FA, Alqahtani YZ. Knowledge, Attitude and Practice Regarding Risk of Diabetic Foot Among Diabetic Patients in Aseer Region, Saudi Arabia. Cureus 2021; 13:e18791. [PMID: 34804657 PMCID: PMC8592378 DOI: 10.7759/cureus.18791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/15/2022] Open
Abstract
Background Diabetic foot care is vital as it is preventable complication but dangerous even a small trauma can end with serious consequences. Diabetes may cause nerve damage that affects feet sensation. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, patients may lose notice of early foot abnormalities. Diabetic patients’ awareness regarding how to care for their feet plays a significant role in preventing these complications. Methods A correlation cross-sectional study was conducted targeting all diabetic patients aging 20 years or more. Online questionnaire was used for data collection. Questionnaire was uploaded online using social media platforms by the researchers and their relatives and friends. The questionnaire included patient personal data, patients’ knowledge regarding diabetic foot, attitude and practice regarding the risk of diabetic foot among diabetic patients. Results A total of 1,000 diabetic patients fulfilling the inclusion criteria completed the study questionnaire. Exact of 77.5% of the patients know that Diabetics can get gangrene in the foot, 74.9% know diabetics can develop ulcers in the foot, 66.7% reported that Diabetes can reduce blood flow to the feet of diabetic patients, 66.6% agreed that diabetic patients can suffer from a lack of sensation in the feet. Exact of 84.5% of the study participants agreed that Diabetics should check for any wounds on their feet daily, 78.7% agreed that Diabetics should visit a doctor when there is any infection or wound in the feet, 76.6% think that diabetic patients should wear specialized shoes to avoid diabetic foot according to the doctor's instructions. A total of 822 (82.2%) of the study patients wash their feet daily, and 295 (29.5%) usually wear cotton socks regularly and 39.6% sometimes wear the stock. Only 192 (19.2%) regularly walk barefoot and 41.7% sometimes do. Conclusion In conclusion, the current study results showed that nearly two out of each three diabetic patients were knowledgeable for diabetic foot and its care. High knowledge was associated with young age, high education and having family member with diabetes mellitus (DM). Also, patients had a good attitude towards diabetic foot care and the effect of diabetes on foot health with to some level accepted practice except for some issues.
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Affiliation(s)
- Ali M Al Amri
- Family Medicine & Diabetes, Asir Central Hospital, Abha, SAU
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Alsaleh FM, AlBassam KS, Alsairafi ZK, Naser AY. Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: A cross-sectional study. Saudi Pharm J 2021; 29:506-515. [PMID: 34194257 PMCID: PMC8233518 DOI: 10.1016/j.jsps.2021.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/12/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a major public health issue and is the main cause of morbidity and mortality worldwide. At the time of diagnosis, many patients with type 2 diabetes (T2D) have one or two risk factors for diabetic foot diseases, such as diabetic peripheral neuropathy (DPN) and diabetic foot ulcers (DFUs). Patients can overcome such complications through good knowledge and practice of foot self-care. This study aims to evaluate the knowledge and practice of foot care among patients with diabetes mellitus attending primary healthcare centres (PHCs) in Kuwait and to identify those at risk for developing DPN. METHODS A cross-sectional study was conducted using a pre-tested self-administered questionnaire. The questionnaire included questions on demographic characteristics and patients' knowledge and practices of foot care. Adult patients (aged 21 and above) with a diagnosis of diabetes mellitus for at least 1 year were randomly selected from PHCs located in the five governorates of Kuwait. Data were analysed using SPSS, version 26. RESULTS A total of 357 patients participated in this study, giving a response rate of 87.3%. The overall mean knowledge score of foot care was 12.7 ± 2.7 (equals 81.3%). Most patients (n = 283, 79.3%) showed good knowledge. In comparison, less than one-third of patients (n = 110, 30.8%) practiced good foot care. The overall mean score of patients' practices was 55.7 ± 9.2 (equals 64.0%). Approximately 17.4% of the patients had a higher risk of developing DPN. University students had lower odds of having good knowledge about foot care [OR: 0.19 (95%CI: 0.04-0.86)]. On the other hand, patients who reported having diabetes for a long duration (10 years and above) [OR: 1.88 (95%CI: 1.11-3.18)] and patients who did not have any other comorbidities [OR: 0.49 (95%CI: 0.26-0.90)] had higher odds of having good foot care knowledge. Patients who were on oral hypoglycaemic agents (OHAs) only had lower odds [OR: 0.63 (95%CI: 0.39-1.00)] of practicing good foot care. Patients who reported having diabetes for a duration between 5 to less than 10 years [OR: 1.75 (95%CI: 1.06-2.90)] and those who are on a diet only [OR: 1.76 (95%CI: 1.06-2.94)] had higher odds of practicing good foot care. Patients who were using combination therapy with OHAs and insulin had a higher risk [OR: 2.67 (95%CI: 1.11-6.41)] of developing DPN. On the other hand, patients who reported that they did not have a previous history of foot ulcer had a lower risk of developing DPN [OR: 0.21 (95%CI: 0.09-0.47)]. CONCLUSION The knowledge of patients with diabetes regarding foot care is rated as good, while their self-practice is considered satisfactory. To improve the foot care knowledge and self-care practice of patients, healthcare providers (HCPs) need to support patients through educational programmes and appropriate training.
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Affiliation(s)
- Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Khaled S. AlBassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait
| | - Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
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Elkashif MML, Mahdy AY, Elgazzar SE. Evaluating The Effect of Establishing Protocol for Self- Care Practice of Diabetic Foot Patients Regarding Their Needs, Concerns and Medication Use: A quasi-experimental study. Saudi J Biol Sci 2021; 28:3343-3350. [PMID: 34121871 PMCID: PMC8176041 DOI: 10.1016/j.sjbs.2021.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/25/2021] [Indexed: 11/28/2022] Open
Abstract
The practice of diabetic self-care plays a significant role in maintaining and preventing diabetic foot complications, but low commitment to self-care practices is common. This study evaluates the effect of establishing protocol for self-care practice of diabetic foot patients according to their needs, concerns, and medication use. A quasi-experimental research (pre-test and post-test) design was used in outpatient clinics at Benha University Hospital, Egypt. The study included 100 adult patients diagnosed with diabetes (types I and II) for at least six months. The findings revealed that 79% suffered from burning or tingling in legs or feet; 74% complained of presence of redness of lower limb, legs or foot pain with activity, and loss of lower extremity sensation; and 80% had changes in skin colour or skin lesions. A comparison between the group pre- and post-intervention (protocol) showed that post-intervention patient foot care knowledge and self-care practice scores were higher. Also, 72% of the participants obtained good knowledge related to foot care post- protocol intervention compared to 37% pre- intervention. Based on the findings, the establishing intervention protocol fosters self-care practice and knowledge regarding needs, concerns, and medication use among diabetic foot patients. Therefore, this protocol can be applied in health practice and research in order to prevent diabetic foot ulcer, and thereby foot amputation.
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Affiliation(s)
- Mirfat Mohamed Labib Elkashif
- Department of Nursing Sciences, College of Applied Medical Sciences in Wadi Alddawasir, Prince Sattam bin Abdulaziz University, 18616, Saudi Arabia
| | - Abeer Yahia Mahdy
- Departement of Medical Surgical Nursing, College of Nursing, Najran University, Saudi Arabia
- Department of medical surgical nursing, Faculty of nursing, Benha University, Egypt
| | - Samia Eaid Elgazzar
- Departement of Medical surgical Nursing, Faculty of Nursing, Port Said University, Egypt
- Departement of Medical Surgical Nursing, College of Nursing, Qassim University, Saudi Arabia
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Pavithra H, Akshaya KM, Nirgude AS, Balakrishna AG. Factors associated with awareness and practice about foot care among patients admitted with diabetes mellitus: A cross sectional research from a medical college hospital of southern India. Nepal J Epidemiol 2020; 10:897-904. [PMID: 33042593 PMCID: PMC7538014 DOI: 10.3126/nje.v10i3.29213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 09/20/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022] Open
Abstract
Background Diabetes Mellitus (DM) causes micro and macro vascular complications. One of the complications of DM is diabetic foot that results in amputations and decreased quality of life. The aim of this study was to assess the awareness and practice about foot care and associated factors among admitted patients in a teaching hospital of coastal Karnataka, India. Material and Methods A cross-sectional study was conducted in a medical college hospital after obtaining institutional ethics approval from 24th December 2016 to 21st January 2017. Adults with diabetes (N=317) admitted in the hospital were interviewed with a validated structured questionnaire for awareness and practice regarding foot care. The scores obtained were further graded into good and poor. Data was analyzed with SPSS version 22 for descriptive statistics. Bivariate logistic and linear regressions were used to determine the association between variables and awareness/practice scores. Results Mean age of the participants was 56.98 (±10.54) years with males constituting the majority (63.4%). Good awareness and practice scores were observed among 69.1% and 41.6% participants, respectively. Good awareness scores were associated with male patients (p=0.027), currently not married (p=0.044), below poverty line socioeconomic status (p=0.014) and presence of foot ulcer (p=0.021). Good practice scores was associated with secondary schooling (p=0.003) and receiving insulin (p=0.045). Moderate correlation with coefficient 0.493 (p<0.001) was observed between awareness and practice scores. Conclusion Seven and four out of 10 study participants had good awareness and practice scores about foot care, respectively. A tailor-made health education module addressing the lacunae identified in the awareness and practice domains needs to be provided to the patients with diabetes mellitus.
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Affiliation(s)
- H Pavithra
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - Kibballi Madhukeshwar Akshaya
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - Abhay Subashrao Nirgude
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
| | - A G Balakrishna
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India, 575018
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Xiong XF, Wei L, Xiao Y, Han YC, Yang J, Zhao H, Yang M, Sun L. Family history of diabetes is associated with diabetic foot complications in type 2 diabetes. Sci Rep 2020; 10:17056. [PMID: 33051498 PMCID: PMC7555504 DOI: 10.1038/s41598-020-74071-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/18/2020] [Indexed: 12/20/2022] Open
Abstract
To investigate the relationship between diabetic foot complications (DFCs) and clinical characteristics, especially the number and types of first-degree family members with diabetes. A total of 8909 type 2 diabetes patients were enrolled. The clinical characteristics of these patients, including DFCs and family history of diabetes (FHD), were collected from medical records. Multiple regression was used to investigate the association between FHD and DFCs after adjusting for confounding factors. The patients with one and more than one first-degree family member with diabetes accounted for 18.7% and 12.8%, respectively. The proportions of the participants with a father with diabetes, a mother with diabetes, both parents with diabetes, siblings with diabetes, father and siblings with diabetes, mother and siblings with diabetes, and both parents and siblings with diabetes were 3.5%, 6.2%, 1.1%, 14.4%, 1.5%, 4%, and 0.7%, respectively. The multiple regression analysis showed that the number of family members with diabetes was positively associated with DFCs. However, among the different types of FHD, only the patients with a mother with diabetes showed a statistical association with DFCs. In addition to FHD, other factors, including gender, body mass index, platelet count, hemoglobin levels, albumin levels, high-density cholesterol levels, diabetic peripheral neuropathy, and the use of lipid-lowering agents, oral hypoglycemic agents, and insulin, were also associated with DFCs. DFCs were associated with different numbers of family members with diabetes and types of FHD. This association reveals the importance of genetic and environmental factors in DFCs and highlights the importance of adding FHD to public health strategies targeting detecting and preventing the disease.
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Affiliation(s)
- Xiao-Fen Xiong
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ling Wei
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ying Xiao
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ya-Chun Han
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Jinfei Yang
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Hao Zhao
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ming Yang
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Lin Sun
- Department of Nephrology, The Second Xiangya Hospital at Central South University, Hunan Key Laboratory of Kidney Disease and Blood Purification, No.139 Renmin Middle Road, Changsha, 410011, Hunan, China.
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Hanley G, Chiou PY, Liu CY, Chen HM, Pfeiffer S. Foot care knowledge, attitudes and practices among patients with diabetic foot and amputation in St. Kitts and Nevis. Int Wound J 2020; 17:1142-1152. [PMID: 32744425 DOI: 10.1111/iwj.13446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/09/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022] Open
Abstract
About one-third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related to diabetes foot and amputation remain unknown. This study investigated factors associated with diabetic foot and amputation (DFA). Retrospective case control study design, and purposive and quota sampling method was used to recruit the participants. Patients with and without DFA were interviewed at two main hospitals, several primary health centres, and a private doctor's office during July and August 2018. Self-development questionnaires were applied to assess patients' demographic, physical and behaviour, foot care knowledge, attitudes, and practices related to DFA. Chi-square, t-test, and multiple logistic regressions were used to analyse the data. A total of 210 patients were evaluated, 89 had DFA, while 121 did not, with a mean age of 61.10 (SD = 11.85). Participants' responses indicated good knowledge, favourable attitudes, and adequate practices related to foot care. The two items of the questionnaire, ways to maintain blood flow in the lower extremities and wash their feet daily, had significant lower score in DFA group. In multiple logistic regression, knowledge, attitudes, and practices related to foot care were not a significant predictor of DFA. Being male was a predictor of DFA than female (OR = 3.53; 95% CI = 1.65-7.57; P < .01). Participants who were currently unemployed were less likely to have DFA than those who were employed (OR = 0.38; 95% Cl = 0.17-0.86; P < .05). Comparing patients with the longest experience of diabetes mellitus (31 years or more) with those who had diabetes for the shortest period of time (between 1 and 10 years) was less likely to have DFA (OR = 0.38; 95% CI = 0.15-0.97; P = <.05). The combination of these independent variables could explain 29% of the variance in DFA. Based on these findings, strategies to prevent diabetic foot and amputation should focus on male and outdoor heavy worker, and longer duration of diabetes patients which are identified in this study.
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Affiliation(s)
- Gracelyn Hanley
- Department of Nursing, Alexandra Hospital, Charlestown, Saint Kitts and Nevis
| | - Piao-Yi Chiou
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Hui-Mei Chen
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Stefani Pfeiffer
- International and Cross-strait Education Center, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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15
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Ferreira ACBH, Ferreira DD, Oliveira HC, Resende ICD, Anjos A, Lopes MHBDM. Competitive neural layer-based method to identify people with high risk for diabetic foot. Comput Biol Med 2020; 120:103744. [PMID: 32421649 DOI: 10.1016/j.compbiomed.2020.103744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVE To automatically identify patients with diabetes mellitus (DM) who have high risk of developing diabetic foot, via an unsupervised machine learning technique. METHODS We collected a new database containing 54 known risk factors from 250 patients diagnosed with diabetes mellitus. The database also contained a separate validation cohort composed of 73 subjects, where the perceived risk was annotated by expert nurses. A competitive neuron layer-based method was used to automatically split training data into two risk groups. RESULTS We found that one of the groups was composed of patients with higher risk of developing diabetic foot. The dominant variables that described group membership via our method agreed with the findings from other studies, and indicated a greater risk for developing such a condition. Our method was validated on the available test data, reaching 71% sensitivity, 100% specificity, and 90% accuracy. CONCLUSIONS Unsupervised learning may be deployed to screen patients with diabetes mellitus, pointing out high-risk individuals who require priority follow-up in the prevention of diabetic foot with very high accuracy. The proposed method is automatic and does not require clinical examinations to perform risk assessment, being solely based on the information of a questionnaire answered by patients. Our study found that discriminant variables for predicting risk group membership are highly correlated with expert opinion.
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Affiliation(s)
| | - Danton Diego Ferreira
- Automation Department, Universidade Federal de Lavras, Lavras, Minas Gerais, Brazil.
| | | | | | - André Anjos
- Idiap Research Institute, Martigny, Switzerland
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Ponnam H, Lamba C, Oberai P, Masood S, Yandamuri S, Rao MN, Manchanda R. Calendula mother tincture vs normal saline for ulcer dressing as an add-on to Individualized Homoeopathic Intervention in the management of Diabetic Foot Ulcer: A Randomized Controlled Pilot Study. INDIAN JOURNAL OF RESEARCH IN HOMOEOPATHY 2020. [DOI: 10.4103/ijrh.ijrh_87_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mogre V, Johnson NA, Tzelepis F, Shaw JE, Paul C. A systematic review of adherence to diabetes self‐care behaviours: Evidence from low‐ and middle‐income countries. J Adv Nurs 2019; 75:3374-3389. [DOI: 10.1111/jan.14190] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/20/2019] [Accepted: 08/05/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Victor Mogre
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Department of Health Professions Education School of Medicine and Health Sciences University for Development Studies Tamale Ghana
| | - Natalie A. Johnson
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
| | - Flora Tzelepis
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
- Hunter New England Population Health Hunter New England Local Health District Wallsend New South Wales Australia
| | | | - Christine Paul
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
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Khunkaew S, Fernandez R, Sim J. Health-Related Quality of Life and Self-Care Management Among People With Diabetic Foot Ulcers in Northern Thailand. SAGE Open Nurs 2019; 5:2377960819825751. [PMID: 33415216 PMCID: PMC7774360 DOI: 10.1177/2377960819825751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/13/2018] [Accepted: 12/28/2018] [Indexed: 11/17/2022] Open
Abstract
Diabetic foot ulcers (DFUs) are a common complication of diabetes that impacts on the health-related quality of life (HRQOL). Foot care is an important factor in the self-care management of patients with DFUs. The objective of this study was to investigate the HRQOL and foot care management of people with DFUs. A cross-sectional study involving 41 people with DFUs was conducted at a large tertiary hospital in Northern Thailand. The Diabetic Foot Ulcer Scale-Short Form and the VA-Diabetes Foot Care Survey were used to assess the HRQOL and foot care management among people with DFUs. The majority of the participants were female (n = 24, 58.5%), and the mean age was 62.13 years. The scores for HRQOL in the six domains were as follows: leisure (66.95 ± 28.03), physical health (68.93 ± 28.51), dependence or daily life (80.08 ± 25.23), negative emotions (71.23 ± 29.48), worried about ulcers (62.20 ± 31.97), and bothered by ulcer care (69.36 ± 25.20). High scores indicate a high (good) HRQOL. Less than a third of the participants reported that they had received education about foot care management. Almost all participants reported that they washed their feet daily; however, a large proportion did not test the water temperature or use lubricants on their feet. Most of the participants did not have a mirror for checking under their feet (48.8%), and there was a lack of knowledge about how to use a mirror for foot inspections (51.2%). This study provides guidance for clinicians on the content and delivery of diabetes education programs for people with diabetes (and DFUs) in Northern Thailand. The findings provide guidance on existing knowledge and the need for programs to address barriers to foot self-care management both in terms of skills and attitudes.
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Affiliation(s)
- Saneh Khunkaew
- School of Nursing, University of Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, New South Wales, Australia
| | - Jenny Sim
- School of Nursing, University of Wollongong, New South Wales, Australia
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Steffy K, Shanthi G, Maroky AS, Selvakumar S. Potential bactericidal activity of S. nux-vomica-ZnO nanocomposite against multidrug-resistant bacterial pathogens and wound-healing properties. J Trace Elem Med Biol 2018; 50:229-239. [PMID: 30262284 DOI: 10.1016/j.jtemb.2018.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 01/13/2023]
Abstract
Multidrug resistance in bacterial strains has become the greatest challenge for healthcare professionals for treating non-healing ulcers such as diabetic foot infections (DFI). Plant-mediated synthesis of S. nux-vomica-ZnO nanocomposite appears as a potential new alternative therapeutic agent that might be capable of tackling antibiotic-resistant bacterial pathogens and for treating a non-healing ulcer. The aim of the study was to investigate the antibacterial potential of S. nux-vomica-ZnO nanocomposite biosynthesised from Strychnos nux-vomica against multidrug-resistant organisms (MDROs) from DFU, wound-healing properties, and cytotoxic effects. The antibacterial potential was assessed by minimum inhibitory concentration (MIC)/ minimum bactericidal concentration (MBC) assays, time-kill kinetics, protein-leakage, and flow cytometric analysis. The wound-healing properties were assessed by scratch assay on mouse L929 fibroblastic cell line to quantify cell migration towards the injured area. Cytotoxicity was assessed using 3-[4,5-dimethyl-2-thiazol-yl]-2,5-diphenyl- 2H-tetrazolium bromide (MTT) cellular viability assay on the L929 cell line and human embryonic kidney epithelial (HEK-293) cell line. Strychnos nux-vomica-ZnO nanocomposite at a size range of 10-12 nm exhibited significant bactericidal potency at a concentration of 100-200 μg/ml against MDR-Methicillin-resistant Staphylococcus aureus, MDR-Escherichia coli, MDR-Pseudomonas aeruginosa, MDR-Acinetobacter baumannii, and also against standard bacterial strains S. aureus ATCC 29213, E. coli ATCC 25922, P. aeruginosa ATCC 27853, E. faecalis ATCC 29212. S. nux-vomica-ZnO nanocomposite also exhibited wound-healing and reduced cytotoxic properties at the antimicrobially active concentrations. Our findings thus suggested remarkable bactericidal properties of S. nux-vomica-ZnO nanocomposite and can be further exploited towards for the development of an antibacterial agent against the threatening superbugs.
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Affiliation(s)
- Katherin Steffy
- Division of Microbiology, Rajah Muthiah Medical College, Annamalai University, Chidambaram, 608002, Tamil Nadu, India.
| | - G Shanthi
- Division of Microbiology, Rajah Muthiah Medical College, Annamalai University, Chidambaram, 608002, Tamil Nadu, India
| | - Anson S Maroky
- Department of Pharmacy, Faculty of Engineering and Technology, Annamalai University, Chidambaram, 608002, Tamil Nadu, India
| | - S Selvakumar
- Department of Zoology, Faculty of Science, Annamalai University, Chidambaram, 608002, Tamil Nadu, India
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20
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Ebadi Fardazar F, Tahari F, Solhi M. Empowerment of type 2 diabetic patients visiting Fuladshahr diabetes clinics for prevention of diabetic foot. Diabetes Metab Syndr 2018; 12:853-858. [PMID: 29731336 DOI: 10.1016/j.dsx.2018.04.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022]
Abstract
AIMS Diabetic foot is one of the most serious and costly complications of diabetes. Empowerment is an important indicator in promoting foot care behaviors that helps patients to use their maximum abilities. This study was carried out with the aim of empowering patients with type 2 diabetes to prevent diabetic foot in the city of Fuladshahr, Isfahan, Iran. METHODS This is a quasi-experimental study. 104 eligible patients were randomly assigned to two groups: intervention group and control group. The data were collected through a form of profile, empowerment questionnaire, and foot care behavior checklist. The questionnaires were completed by the two groups in the pre-intervention, 1 and 3 months after the end of the intervention. Data were analyzed in SPSS22 using independent t-test, paired t-test, Chi-square, ANOVA, LSD post hoc test and repeated data analysis. RESULTS The results showed that there was no significant difference between two groups in terms of demographic variables. Independent t-test showed that there was no significant difference between the two groups in terms of mean score of empowerment and foot care behavior before intervention. However, the mean score of empowerment and foot care behavior of the experiment group was significantly higher than that of the control group in 1 and 3 months after the intervention (P < 0.001). CONCLUSION The empowerment of diabetic patients is effective in promoting foot care behavior, and implementation of empowerment programs in diabetes clinics in this city is recommended.
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Affiliation(s)
- Farbod Ebadi Fardazar
- Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Tahari
- Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran.
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21
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Silva NC, Chaves ÉC, Carvalho EC, Carvalho LC, Iunes DH. Effect of Foot Reflexology on Capillary Blood Glucose, Tissue Temperature, and Plantar Pressure of Individuals With Diabetes Mellitus (Type 2): A Pilot Study. J Chiropr Med 2018; 17:182-189. [PMID: 30228809 PMCID: PMC6141416 DOI: 10.1016/j.jcm.2018.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/01/2018] [Accepted: 03/21/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the effect of foot reflexology on capillary blood glucose, feet tissue temperature, and plantar pressure of the feet of individuals with diabetes mellitus (type 2). METHODS Forty-five individuals with type 2 diabetes mellitus were stratified into 2 groups: treated (n = 21), which received orientation about foot self-care and received 12 foot reflexology sessions; and control (n = 24), which received only orientations about foot self-care. A portable glucose meter, an infrared thermography camera, and a baropodometer evaluated the variables. RESULTS The data indicate that, after 12 therapy sessions, there were no significant differences between the groups for producing effects on capillary blood glucose, feet tissue temperature, and plantar pressure. CONCLUSION No significant effect was observed after 12 foot reflexology sessions in the variables that were evaluated.
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Affiliation(s)
- Natália C.M. Silva
- School of Nursing, Federal University of State of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Emília C. Carvalho
- Nursing School at Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Leonardo C. Carvalho
- Course of Physiotheraphy/Nursing School, Federal University of Alfenas, Minas Gerais, Brazil
| | - Denise H. Iunes
- Course of Physiotheraphy/Nursing School, Federal University of Alfenas, Minas Gerais, Brazil
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Indrayana S, Guo SE, Lin CL, Fang SY. Illness Perception as a Predictor of Foot Care Behavior Among People With Type 2 Diabetes Mellitus in Indonesia. J Transcult Nurs 2018; 30:17-25. [PMID: 29699462 DOI: 10.1177/1043659618772347] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Illness perception may contribute to foot care behavior because people with type 2 diabetes mellitus (T2DM) in Indonesia may have different beliefs that influence their foot care behaviors. This study aimed to determine the relationships among foot care knowledge, illness perception, local beliefs, and foot care behaviors in people with T2DM in Indonesia. METHODS Cross-sectional study with a convenience sampling technique was used to recruit 200 people with T2DM from the Outpatient Department of Islamic Hospital. The Foot Care Knowledge, Brief Illness Perception, Local Beliefs, and Foot Self-Care Behavior questionnaires were administered. RESULTS The predictors of foot care were having a family member or friend with diabetic foot ulcer ( p = .001), diabetes mellitus duration ( p = .026), foot care knowledge ( p < .001), consequences ( p < .001), treatment control ( p < .001), and local beliefs ( p = .017). DISCUSSION Health care providers may cultivate a spiritual approach, providing success stories to create positive images of the disease's outcomes and increase patients' confidence to control the disease.
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Affiliation(s)
| | - Su-Er Guo
- 2 Chang Gung University of Science and Technology, Chiayi, Taiwan.,3 Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Fundation, Chiayi, Taiwan.,4 Ming Chi University of Technology, Taipei, Taiwan
| | | | - Su-Ying Fang
- 5 National Cheng Kung University, Tainan, Taiwan
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Khani Jeihooni A, Eskandarzadeh N, Dehghan A, Khiyali Z, Bahmandoost M. Investigation of the Performance of Foot and Eye Care in Patients with Type II Diabetes in Fasa: An Application of the Theory of Planned Behavior. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2017. [DOI: 10.21859/jech-03036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hassan ZM. Mobile phone text messaging to improve knowledge and practice of diabetic foot care in a developing country: Feasibility and outcomes. Int J Nurs Pract 2017. [DOI: 10.1111/ijn.12546] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Taksande BA, Thote M, Jajoo UN. Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India. J Family Med Prim Care 2017; 6:284-287. [PMID: 29302533 PMCID: PMC5749072 DOI: 10.4103/2249-4863.219994] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Diabetic foot syndrome is one of the common and most devastating preventable complications of diabetes mellitus (DM). It is associated with morbidity and premature mortality due to long-term complications affecting foot. The American Diabetes Association recommends that people with diabetes should have a comprehensive foot examination once per year. Most of the foot problems can be prevented with careful foot care. It may take effort and time to build up good foot care habits, but self-care is essential. Aim: The main aim of the study is to analyze the knowledge, attitude, and practice of foot care in patients with DM in central rural India. Methodology: This study was conducted at a rural educational hospital in central part of India over 200 patients who have Type 1 and Type 2 diabetes. They were evaluated for their knowledge about foot care and footwear practices. A structured and validated questionnaire was administered to cases. Results: Around 82.9% of the patients were aware of the disease and 23.2% were aware of the complications of the DM. In 63% of the patients, foot care examination and education regarding foot complications were not suggested by their treating physicians. Annual examination of feet by the physician and self-examination were not known facts to the diabetic population. Conclusion: It is necessary to firstly develop awareness of diabetes mellitus and the related complications, one amongst which is foot care. Certain educational strategies should be established for both the consultant physician and also the common man to create awareness for effective foot care.
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Affiliation(s)
- Bharati Amar Taksande
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Mukesh Thote
- Consultant Physician, Bhandara, Maharashtra, India
| | - U N Jajoo
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
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Goie TT, Naidoo M. Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-e8. [PMID: 28155315 PMCID: PMC5125263 DOI: 10.4102/phcfm.v8i1.1170] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 07/07/2016] [Accepted: 06/12/2016] [Indexed: 12/30/2022] Open
Abstract
Background Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM). Methods An observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa. Results Two hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05). Conclusion The study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.
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Affiliation(s)
- Thea T Goie
- Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban.
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Hjelm K, Apelqvist J. Influence of beliefs about health and illness on self-care and care-seeking in foreign-born people with diabetic foot ulcers: dissimilarities related to origin. J Wound Care 2016; 25:602-616. [DOI: 10.12968/jowc.2016.25.11.602] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- K. Hjelm
- Department of Social and Welfare Studies, University of Linköping, Campus Norrköping, Sweden
| | - J. Apelqvist
- Department of Endocrinology, Skåne University Hospital, Malmö, Lund University, Sweden
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Silva RN, Ferreira ACBH, Ferreira DD, Barbosa BHG. Non-invasive method to analyse the risk of developing diabetic foot. Healthc Technol Lett 2015; 1:109-13. [PMID: 26609394 DOI: 10.1049/htl.2014.0076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 11/20/2022] Open
Abstract
Foot complications (diabetic foot) are among the most serious and costly complications of diabetes mellitus. Amputation of all or part of a lower extremity is usually preceded by a foot ulcer. To prevent diabetic foot, an automatic non-invasive method to identify patients with diabetes who have a high risk of developing diabetic foot is proposed. To design the proposed method, information concerning social scope and self-care of 153 diabetic patients was presented to the K-means clustering algorithm, which divided the data into two groups: high risk and low risk of developing diabetic foot. In the operational stage, the Euclidian distance from the information vector to the centroids of each group of risk is used as criterion for classification. Both real and simulated data were used to evaluate the method in which promising results were achieved with accuracy of 0.97 ± 0.06 for simulated data and 0.68 ± 0.16 considering the classification of specialists as the gold standard for real data. The method requires a simple computational processing and can be useful for basic health units to triage diabetic patients helping the health-care team to reduce the number of cases of diabetic foot.
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Affiliation(s)
- Rebeca N Silva
- Engineering Department , Federal University of Lavras , Lavras , Minas Gerais 3030/37200-000 , Brazil
| | - Ana C B H Ferreira
- School of Nursing , Federal University of Juiz de Fora , Juiz de Fora , MG 36036-900 , Brazil
| | - Danton D Ferreira
- Engineering Department , Federal University of Lavras , Lavras , Minas Gerais 3030/37200-000 , Brazil
| | - Bruno H G Barbosa
- Engineering Department , Federal University of Lavras , Lavras , Minas Gerais 3030/37200-000 , Brazil
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Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM. Knowledge and Practice of Diabetic Foot Care in an In- Patient Setting at a Tertiary Medical Center. Malays Orthop J 2015; 8:22-6. [PMID: 26401231 DOI: 10.5704/moj.1411.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.
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Affiliation(s)
- A R Muhammad-Lutfi
- Department of Orthopaedics ,Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
| | - M R Zaraihah
- Department of Orthopaedics ,Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
| | - I M Anuar-Ramdhan
- Department of Orthopaedics ,Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia
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Abstract
As the majority of diabetic foot ulcers are avoidable, patients with diabetes should be routinely screened for risk factors. When such factors are present, holistic assessment followed by rapid referral to the appropriate member of the multidisciplinary team will ensure that preventive measures are implemented to avoid the occurrence of ulcers. Best results will be achieved if the patient is fully involved in this process.
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Affiliation(s)
- Bahle Nteleki
- Podiatrist, Stanza Bopape Community Health Centre, Pretoria, South Africa
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Iunes DH, Rocha CBJ, Borges NCS, Marcon CO, Pereira VM, Carvalho LC. Self-care associated with home exercises in patients with type 2 diabetes mellitus. PLoS One 2014; 9:e114151. [PMID: 25479542 PMCID: PMC4257588 DOI: 10.1371/journal.pone.0114151] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 11/02/2014] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to verify self-care guidelines together with lower limb home exercises alter ankle and foot plantar pressure and alignment in patient with Type 2 Diabetes Mellitus (DM) measuring health and sociodemographic factors. The health factors analyzed were sensitivity and circulation aspects, risk rating, and neuropathy symptom score, ankle and foot alignment (photogrammetry), plantar pressures, and postural stability (baropodometry) before and after administering these guidelines and home exercises in 97 patients type 2 DM during 10 months. The self-care guidelines and exercises changed the forefoot alignment (Right Foot – Initial vs Final, p = 0.04; Left Foot, P<0.01), the center of the force displacement in the mediolateral (Right Foot - Initial versus Final, p = 0.02; Left Foot, P<0.01), and the anterior-posterior (Right foot - Initial versus Final, p = 0.01) direction, and body balance (Initial versus Final, p = 0.02). There was no change in the remaining assessed parameters. Self-care associated with the guidelines for home exercises for the lower limbs in patients with type 2 DM are effective in maintaining and improving the alignment of the feet, mediolateral stability and prevention of complications. Trial Registration The Brazilian Clinical Trials Registry RBR-8854CD
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Saurabh S, Sarkar S, Selvaraj K, Kar SS, Kumar SG, Roy G. Effectiveness of foot care education among people with type 2 diabetes in rural Puducherry, India. Indian J Endocrinol Metab 2014; 18:106-110. [PMID: 24701439 PMCID: PMC3968714 DOI: 10.4103/2230-8210.126587] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The burden of diabetes and its foot complications is increasing in India. Prevention of these complications through foot care education should be explored. The objective of our study was to assess the risk factors of poor diabetic foot care and to find the effectiveness of health education in improving foot care practice among diabetes patients. MATERIALS AND METHODS A structured pre-tested questionnaire was administered to the outpatients of a rural health center with type 2 diabetes. Awareness regarding diabetes, care of diabetes and foot care practice ware assessed and scored. Individual and group health education focusing on foot care was performed. Foot care practice was reassessed after 2 weeks of education. RESULTS Only 54% were aware that diabetes could lead to reduced foot sensation and foot ulcers. Nearly 53% and 41% of the patients had good diabetes awareness and good diabetes care respectively. Only 22% of the patients had their feet examined by a health worker or doctor. The patients with poor, satisfactory and good practice scores were 44.7%, 35.9% and 19.4% respectively. Low education status, old age and low awareness regarding diabetes were the risk factors for poor practice of foot care. Average score for practice of foot care improved from 5.90 ± 1.82 to 8.0 ± 1.30 after 2 weeks of health education. Practice related to toe space examination, foot inspection and foot wear inspection improved maximally. CONCLUSION Foot care education for diabetics in a primary care setting improves their foot care practice and is likely to be effective in reducing the burden of diabetic foot ulcer.
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Affiliation(s)
- Suman Saurabh
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Kalaiselvi Selvaraj
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - S. Ganesh Kumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Gautam Roy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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